Priapism: causes, symptoms and treatment

To answer the question of what is priapism , we must say that this term refers to a persistent erection of the penis that causes pain and does not occur as a result of stimulation or sexual desire. It is not a very common problem and can affect men of any age. This erection can last even hours and although an orgasm is experienced, it does not disappear and the pain in the penis remains, so it is a reason for medical urgency.

This condition receives the name of priapism due to the Greek god of fertility called Priapus, who was always represented with a large phallus in persistent erection as a symbol of the fertilizing force present in nature.

Unlike a normal erection, when you suffer from priapism, the shaft of the penis is firm but the glans is white, so only the cavernous bodies are erected and not the spongy tissue in which the urethra is housed. and in which the glans is included.

The prolonged and painful erection caused by priapism occurs when, due to some change in the circulation of the blood, the blood vessels or the nerves, an abnormal variation occurs in the normal flow of the blood, causing it to be retained in the veins that supply the penis and, therefore, that it remains firm and erect for very long periods of time.

The causes of priapism can be diverse, but among the most common are those listed below:

• Diseases and conditions of the blood , such as sickle cell anemia , leukemia, thalassemia, and myeloma.
• Nervous system disorders , especially spinal cord injuries, including for example multiple sclerosis.
• Consumption of some medications: some drugs could cause priapism as a side effect, this may be the case of medications for erectile dysfunction, antidepressants, antipsychotics, anticoagulants or those intended to treat hypertension.
• Use of drugs , such as cocaine, heroin, marijuana, or alcohol.
• Trauma to the genital area, groin, or pelvis.
• Metabolic diseases , such as diabetes, gout, nephrotic syndrome, amyloidosis, etc.

It should be noted that there are cases in which specialists cannot identify the exact cause of priapism.

To talk about the symptoms of priapism , first of all it is necessary to clarify that two types of priapism can be distinguished: the ischemic or low-flow and the non-ischemic or high-flow.

Ischemic priapism

It happens when the blood does not flow properly from the penis to the body, being completely retained in the first. This situation causes symptoms such as the following:

• Persistent erection with a duration that exceeds 4 hours and that has not been produced by any type of stimulation or sexual arousal.
• The shaft of the penis is rigid, while the glans is soft.
• Painful erection
• Tenderness in the penis.

Non-ischemic priapism

In this case, there is an excess of blood that flows towards the penis as a result of the rupture of an artery or an injury in the area. Symptoms of non-ischemic priapism include:

• Persistent erection that lasts for at least 4 hours.
• The shaft of the penis is erect, but not rigid.
• In this case, the erection is usually not painful.

In the case of having an erection that lasts more than 4 hours, it is essential to go to the emergency room immediately. Priapism must be diagnosed and treated quickly, since the longer the erection lasts, the more severe the damage to the penile tissues.

The diagnosis of priapism will be based on a first questioning by the doctor to be informed about the patient’s illnesses and the possible consumption of drugs, drugs or alcohol.

In addition, a physical examination and a blood test will be performed. On the other hand, an ultrasound or angiogram of the penis or the extraction of a blood sample from the penis directly may also be ordered.

The treatment of priapism will depend in each case on the type that occurs and the cause that originated it, below we show what are the forms of treatment that are usually applied in ischemic priapism and in non-ischemic priapism.

Treatment of ischemic priapism

So that the erection disappears and the erectile function is not compromised, medical treatment must be immediate. Some drugs and a procedure to drain blood from the penis are usually used:

• The blood is aspirated from the cavernous tissues of the penis applying local anesthesia. With this, pain is relieved and the erection disappears.
• When the above treatment is not enough, injections of phenylephrine can be given into the spongy tissues of the penis in order to limit the amount of blood flow into the penis.
• In cases in which the aspiration does not work, a surgical bypass can be carried out, through which a passage is introduced into the penis in order to return the blood circulation in it to normal.

Treatment of non-ischemic priapism

In many cases, the prolonged erection goes away without any medical treatment. This is usually the result of some type of trauma and because there is no risk of damage to the penis, the specialist may suggest taking a drug or applying ice to ensure that the blood circulates correctly and the erection disappears.

At other times, surgery may be necessary to fix the damage caused by the injury or to place a material that is responsible for temporarily blocking the flow of blood in the penis.

When priapism is treated quickly, the prognosis is usually favorable. However, if this condition does not receive timely medical attention and the erection is very long-lasting, there is a greater chance of serious damage to the tissues of the penis. Untreated priapism can lead to penile thrombosis, erectile dysfunction, or disfigurement of the penis.

Only in very serious cases and in which irreversible damage has occurred, gangrene may occur and castration or penectomy is required.

This article is merely informative, at FastlyHeal .com we do not have the power to prescribe medical treatments or make any type of diagnosis. We invite you to see a doctor in the case of presenting any type of condition or discomfort.

If you want to read more articles similar to Priapism: causes, symptoms and treatment , we recommend that you enter our category of Male reproductive system .